Individual provider Active NPI

Jeffrey Dubin, LISW-S

  • Clinical Social Worker
  • Columbus, OH
National Provider Identifier
1366696361
Registry record updated Oct 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I0010235 Issued in OH
Practice address
750 E Long St
Columbus, OH 43203-1846
Phone
(614) 340-6700
NPI assigned
Nov 5, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X I0010235 OH Primary

Addresses

Primary practice location

750 E Long St
Columbus, OH 43203-1846

Mailing address

1105 Schrock Rd Ste 400
Columbus, OH 43229-1174
Phone (614) 987-5620

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090519000406 OH Practitioner - Clinical Social Worker 4486703626 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Ohio State University College of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Equitas Health,IncGroup PAC ID 2769638154, 37 clinicians

Practice addresses (Care Compare)

1033 N High St
Columbus, OH 43201-2409
Phone (614) 340-6777

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
I0010235OHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Equitas Health, Inc CurrentSince Jun 21, 2014 Accepting new patients
Equitas Health,Inc CurrentSince Jun 21, 2014 Accepting new patients

Locations

1105 Schrock Rd
Ste 400
Columbus, OH 43229

1033 N High St
Columbus, OH 43201
Phone (614) 340-6776

4400 N High St
Ste 300
Columbus, OH 43214
Phone (614) 299-2437

L3842
Columbus, OH 43260

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1225843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698364800000",
    "number": "1366696361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1105 SCHROCK RD STE 400",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432291174",
            "telephone_number": "614-987-5620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 E LONG ST",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432031846",
            "telephone_number": "614-340-6700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUBIN",
        "first_name": "JEFFREY",
        "name_prefix": "Mr.",
        "credential": "LISW-S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-11-05",
        "last_updated": "2023-10-27",
        "certification_date": "2023-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I0010235",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.